. A manual of diseases of the nose and throat. s, asshown in Fig. 110. 2. Tubercle may be found on the vocal cords, causingunevenness in their contour and thereby interferingwith their proper approximation during vocalization. 3. Thick, tenacious muco-pus brought up from thelungs or derived from an ulcer in the larynx may tem-porarily be deposited upon the vocal cords, thus inter-fering with their action, and when the throat is clearedthe removal of this permits of proper vocalization. 4. The muscles of the larynx may become infiltrated 462 DISEASES OF THE LARYNX. by the tubercle, so that thei
. A manual of diseases of the nose and throat. s, asshown in Fig. 110. 2. Tubercle may be found on the vocal cords, causingunevenness in their contour and thereby interferingwith their proper approximation during vocalization. 3. Thick, tenacious muco-pus brought up from thelungs or derived from an ulcer in the larynx may tem-porarily be deposited upon the vocal cords, thus inter-fering with their action, and when the throat is clearedthe removal of this permits of proper vocalization. 4. The muscles of the larynx may become infiltrated 462 DISEASES OF THE LARYNX. by the tubercle, so that their contraction is interferedwith, and they thus fail to approximate properly thevocal cords. 5. The recurrent laryngeal nerve on one side—morefrequently on the right side—becomes imbedded in thepleuritic exudate at the apices of the lungs, and com-pression neuritis develops, which interferes with in-nervation of the laryngeal muscles, and paresis orparalysis, as a result of this, prevents proper approxi-mation of the vocal cords. Fig. A tubercular ulcer on the left ventricular band and left vocal cord. Pear-sbaped edematous swelling of ary-epiglottic folds, more intense on the sideof the ulceration. (Cohen.) 6. In advanced lesions of the lungs the volume ofair contained, in the thorax may be so much less thannormal that, with the weakened condition of the mus-cular system generally, the blast of expired air is in-sufficient to cause the vocal cords to vibrate properly,and the voice as a result is weak. Unless the tumefaction or growth of the tubercle isextensive, respiration is seldom interfered with, andany dyspnea complained of is a result of the pulmo-nary rather than of the laryngeal lesion. Cough isalways present in tuberculosis, and is due rather to in-volvement of the pleurae than to the laryngeal disease. TUBERCULOSIS OF THE LARYNX. 463 Where the tubercle formation is heaped up tumor-like,as shown in Fig. 5, Plate VII., a hacking, irritatingcough, due to the pr
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